Newsroom

Mukul Arya, M.D., (left), director of New York Methodist Hospital's Center for Advanced Endoscopy, performs a procedure in NYM's endoscopy suite.

Specialists at New York Methodist Hospital (NYM) have broken new ground in the fight against gastrointestinal (GI) cancer through the addition of an advanced nonsurgical treatment. The space-age procedure is called endoscopic submucosal dissection (ESD) and it allows doctors to effectively remove intact tumors located along the interior of the digestive tract. NYM is the first hospital in Brooklyn to offer the procedure, which avoids open surgery while dramatically decreasing a patient's odds of a cancer recurrence.

"Successfully treating a patient with an early-stage cancerous tumor requires cutting out not only the tumor itself but also a thin 'margin' of tissue surrounding that tumor, in case any malignant cancer cells have splintered away from the visible growth and are threatening to spread (metastasize) to other areas of the body," said Mukul Arya, M.D., director of advanced endoscopy at NYM, who performs the procedure. "Removing a malignant tumor in a single piece dramatically reduces the risk of both cancer metastasis and cancer recurrence. Prior to ESD, open surgery was the best way to ensure this for many patients. Thanks to ESD, we can non-surgically remove larger intact gastric tumors. More than 90 percent of patients who undergo ESD do not experience a cancer recurrence."

Endoscopic submucosal dissection can be used to treat tumors or polyps that extend anywhere from the inner space of the digestive tract (lumen) into the submucosa-a deep layer of tissue beyond which a GI cancer spread indicates a more advanced stage of the disease. During ESD, the patient is placed under general anesthesia and a fiber-optic, camera-guided endoscope is snaked down the digestive tract until it reaches the site of the tumor, which may be located in the esophagus, stomach, colon or rectum. A needle at the end of the scope is then used to inject an inert, viscous fluid into the tissue below the cancer, forming a "cushion" that raises the tumor and makes it easier to remove. After that, specialized tools less than half a millimeter in thickness are used to cut the entire tumor away from the digestive tract.

"The benefits of non-invasive endoscopy include less pain, faster recovery time, and no external scarring, allowing patients to undergo an advanced procedure to remove a cancerous tumor and go home within 24 hours," said Smruti Mohanty, M.D., chief of gastroenterology and hepatobiliary disease at NYM. "But more important, ESD allows us to give sicker patients who are not healthy enough to undergo open surgery a much higher chance of a cure than any previous noninvasive techniques.

"Very few hospitals in New York City are able to offer ESD; it is one of the most technically demanding endoscopic procedures, requiring training and a degree of precision that very few physicians are able to achieve," said Dr. Mohanty. "Dr. Arya clears the bar and then some, and in the fight to cure cancer, the thinnest of margins can make all the difference."